小儿紫癜性肾炎应用奥马哈系统结合药师服务的预后管理价值分析

Analysis of the prognostic management value of Omaha System Combined with pharmacist service in children with Henoch Schonlein purpura nephritis

目的探究基于奥马哈系统和药师服务的延续护理对小儿紫癜性肾炎(henoch-schonlein purpura nephritis,HSPN)预后管理的价值。方法选取2016年1月-2019年1月于宁波市妇女儿童医院住院治疗的HSPN患儿46例,利用随机数字表法将其分为2组,其中观察组22例,对照组24例。对照组采用常规儿科护理,观察组在对照组的基础上采用基于奥马哈系统和药师服务的延续护理。比较2组患儿护理前、出院3个月和出院6个月免疫指标、肾炎复发率、治疗依从性和护理满意度。结果出院后,观察组CD4^+T淋巴细胞、CD4^+/CD8^+T淋巴细胞比值高于对照组(均P<0.05),2组CD8^+T淋巴细胞、IgG、IgM、IgA水平比较差异无统计学意义(均P>0.05)。观察组出院6个月HSPN累积复发率为4.55%,与对照组(8.33%)比较差异无统计学意义(P>0.05)。观察组出院3个月、6个月治疗依从性均高于对照组(均P<0.05)。观察组护理满意度为95.45%,对照组护理满意度为70.83%,差异具有统计学意义(P<0.05)。结论与常规护理相比,基于奥马哈系统和药师服务的延续护理虽未显著改善小儿紫癜性肾炎整体免疫指标,但有相关改变趋势,延长随访可能会出现显著差异。

Objective To explore the value of continuous nursing based on Omaha System and pharmacist service for prognosis management of Henoch Schonlein purpura nephritis(HSPN).Methods Forty-six children with HSPN who were hospitalized from January 2016 to January 2019 were randomly divided into two groups,22 in the observation group and 24 in the control group.Routine pediatric nursing was used in the control group,and continuous nursing based on Omaha System and pharmacist service was used in the observation group.The immune indexes,the recurrence rate of nephritis,treatment compliance and nursing satisfaction were compared between the two groups before nursing for 3 months and 6 months after discharge.Results After discharge,the ratio of CD4^+T lymphocyte and CD4^+/CD8^+T lymphocyte in the observation group was higher than those in the control group(all P<0.05).There were no significant difference in the levels of CD8^+T lymphocyte,IgG,IgM and IgA between the two groups(all P>0.05).The cumulative recurrence rate of HSPN in the observation group was 4.55%at 6 months(P>0.05).The treatment compliance of the observation group was higher than that of the control group(8.33%),P<0.05.The treatment compliance of the observation group were higher than that of the control group at 3 and 6 months after discharge(all P<0.05).The nursing satisfaction of the observation group was 95.45%,and that of the control group was 70.83%,the difference was statistically significant(P<0.05).Conclusion Comparing with the routine nursing,the continuous nursing based on Omaha System and pharmacist service does not significantly improve the immune index of children with Henoch Schonlein purpura nephritis,but there is a trend of relevant changes,and there might be significant differences in the extended follow-up.